Aug 1, 2019

Does stress echocardiography add incremental value to baseline ejection fraction for the early identification of candidates for implantable defibrillators?

Open Heart
Josephine MuhrbeckJohanna Sjöblom

Abstract

A reduction in left ventricular ejection fraction (EF) remains the strongest indicator of increased risk of sudden cardiac death after an acute myocardial infarction (AMI). Guidelines recommend that patients with an EF ≤35%, 6-12 weeks after AMI should be considered for implantable cardioverter defibrillator (ICD) therapy. Stress echocardiography is a safe method to detect viability in a stunned myocardium. The purpose of this study was to investigate if stress echocardiography early after AMI could identify ICD candidates before discharge. Ninety-six patients with EF ≤40% early after AMI were prospectively included in a cohort study, and investigated by baseline and stress echocardiography before discharge. Follow-up echocardiography was performed after 3 months. EF, mitral annular plane systolic excursion (MAPSE) and peak systolic velocity (PSV) were determined for each examination. There were 80 (83%) patients who completed the baseline, stress and follow-up echocardiography. Among them there were 32 (40%) patients who met the ICD criteria of EF ≤35% at 3 months. For these patients, EF, MAPSE and PSV were significantly lower than for those patients who recovered. The area under the receiver operating characteristic curve (AU...Continue Reading

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Mentioned in this Paper

Study
Annular Pancreas
Follow-up
Myocardium
Myocardial Infarction
Executive Function
Pressure Support Mechanical Ventilation
Patient Discharge
Prospective Cohort Study
Implantable Defibrillator

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